Kornimate/medical-research-clean huggingface dataset:
family-focused, stress-reduction program to improve the health care of urban children with asthma

Conditions: Asthma

Summary: stress and anxiety can negatively affect children with asthma. reducing the stress of asthmatic children and their families may lead to improved asthma care and fewer asthma symptoms in the children. the purpose of this study is to develop and evaluate a family-focused asthma education program aimed at reducing stress levels and improving asthma care for urban children with asthma.

asthma is a serious, chronic illness that affects 9 million children in the united states. common asthma symptoms include wheezing, shortness of breath, chest tightness, and coughing. asthma attacks can be triggered by a variety of irritants, including mold, pollen, tobacco smoke, or allergies. stress can also cause asthma attacks, and children who experience high levels of stress and anxiety tend to have poor asthma management skills and health outcomes. additionally, family stress can affect the ability of families and caregivers to provide adequate care to children with asthma. currently, few asthma education programs are aimed at helping both children and parents manage stress. the purpose of this study is to evaluate the effectiveness of a stress-reduction family intervention on improving health outcomes in asthmatic children. study researchers will first conduct focus groups with children who have asthma, their parents, and community health organizations to identify barriers to effective asthma management and sources of stress for caregivers; a family-focused intervention will then be developed. fifty families with an asthmatic child will be enrolled and randomly assigned to one of two groups. group 1 participants will partake in four to six home-based, family educational sessions over a 4-month period. sessions will focus on asthma education and stress management techniques for the entire family. one of these sessions may take place at the child's doctor's office as a way to focus on improving parent-doctor communication. group 2 participants will partake in a single home-based asthma education session. study visits for all participants will occur at baseline, month 4, and 6 months post-intervention. at these timepoints, asthma self-management will be assessed through family interviews and observation of the child's inhaler use; tobacco exposure levels will be measured with a urine test; and family functioning and stress levels will be assessed with questionnaires.

Eligibility criteria:
inclusion criteria: * clinical diagnosis of persistent asthma * poorly controlled asthma, as determined by emergency department visit, hospitalization, or steroid burst in the year prior to study entry * primary caregiver is under stress, as determined by a significantly elevated score on measures of stress * receives medicaid or participates in medicaid hmo * resides in the atlanta metropolitan area exclusion criteria: * nonatopic, nonpsychiatric illness that requires daily medication * diagnosis of asthma in the year prior to study entry * homeless * caregiver is unable to complete study screening process * caregiver does not speak english
real-time assessment of stress and stress response

Conditions: Psychiatric Disorder; Stress Reaction; Stress, Psychological; Stress, Physiological

Summary: stress is a complex natural phenomenon, frequently related to a physiological response, including heart rate, heart rate variability, respiratory rate, skin conductance and temperature. the subjective experience varies greatly; broadly, it may be conceived as a freeze, flight, fight, fright or faint response. many studies have demonstrated the negative influence of psychological stress on health and well-being. through the digital phenotyping of physiological and psychological stress reactions, in a controlled laboratory setting (trier social stress test- tsst) and real-life situations, in a population of healthy participants and patients with a major psychiatric disorder, we expect to find reliable and valid digital biomarkers. the results of this study will, therefore, not only contribute to a better understanding of stress and stress response but also have the potential to improve diagnostic and treatment approaches.


Eligibility criteria:
inclusion criteria: * participants are competent to give informed consent. * participants are right handed * german language proficiency as a native speaker or level b1 * diagnosis of a cluster c personality disorder according to icd-10; or * diagnosis of depressive disorder according to icd-10; or * diagnosis of schizophrenia or schizoaffective disorder according to icd-10; or * without a current psychiatric disorder. exclusion criteria: * low intelligence as confirmed by failure to complete regular compulsory education. * pregnancy or over two weeks delay in the menstrual cycle. * previous participation in a psychological trial involving psychosocial stress assessment. * current neurological disorder. * current cardiovascular disorder. * current respiratory disorder. * current substance use or withdrawal. * any change in medication in the previous week.

Keywords: stress, stress reaction, trier social stress test, digital phenotyping
telemedicine-delivered unified protocol for cognitive behavioral therapy for anxiety and depression

Conditions: Diabetes; Type 1 Diabetes

Summary: this project will evaluate a telemedicine-delivered, unified protocol for cognitive-behavioral therapy (up-cbt) enhanced with continuous glucose monitor (cgm) review to target anxiety and depressive symptoms and glycemic control in adults with type 1 diabetes.

the efficacy of the unified protocol for cognitive behavioral therapy (up-cbt) combined with commercial fda-approved continuous glucose monitoring (cgm) will be tested in comparison to cgm only in a randomized controlled clinical trial. the central hypothesis is that the addition of the up-cbt intervention will yield clinically significant improvements in anxiety and depressive symptom severity and glycemic control relative to cgm alone. we will recruit 94 adults (age 18-64) with suboptimally controlled type 1 diabetes and an anxiety or depressive disorder from a national population for an entirely virtual 12-month study over five years, with targeted recruitment of racial/ethnic minorities. in addition to standard measurement of hemoglobin a1c (hba1c) for glycemic control and validated patient-reported outcome (pro) surveys, the study integrates momentary psychological and behavioral data via smartphone-based ecological momentary assessment (ema) with cgm data to assess day-to-day changes in affect, self-management, and glycemia over the course of the trial. qualitative information will be collected from people with type 1 diabetes (t1d) ages 35-64 to solicit suggestions and inform future study decisions. we will create 2-4 focus groups to ask their impressions about our current study and to explore key factors like establishing adult care and attending medical appointments, disease self-management, and adjusting to chronic disease. we will compare interview responses from participant groups who have high vs. low social needs and poor vs. good glycemic control.

Eligibility criteria:
inclusion criteria: * type 1 diabetes (t1d) duration ≥ 6 months * 18-64 years old * hba1c = 7.5-14% * english- or spanish-speaking * anxiety or depressive mood disorder as per structured diagnostic interview. exclusion criteria: * developmental or sensory disability interfering with participation * current pregnancy * bipolar disorders, psychotic disorders, severe eating disorders, severe substance abuse disorders, or acute suicidal risk or self-harm * use of medications or recent medical procedures that would impact glycemic control or use of continuous glucose monitoring (cgm) over the study * received cognitive behavioral therapy (cbt) in last year or plans to initiate cbt; (6) temporary exclusion for recent initiation of psychotropic medication - must be on a stable dose for 6 weeks prior to enrollment.

Keywords: diabetes type 1 diabetes depression anxiety diabetes distress diabetes management diabetes self-care
novel equation for estimating resting energy expenditure

Conditions: Resting Energy Expenditure; Chronic Kidney Disease

Summary: the energy and nutrition states are closely associated with ckd patients complications and outcomes.to reach the energy balance target, we need the accurate resting energy expenditure level of patients. traditional equations are not applicable to ckd patients,so we aim to develop and validate a equation for estimating resting energy expenditure in ckd patients.


Eligibility criteria:
inclusion criteria: * ckd 3-5 stages * age:18-80 years old exclusion criteria: * dialysis and kidney transplantation; * acute complications to hospitalization * 1 month prior to the study; * acute or chronic infections, cancer and other wasting diseases in the past year; * thyroid dysfunction; * acute onset of podagra; musculoskeletal diseases; * respiratory diseases (asthma, pleural effusion, pneumothorax, copd); * history of hormonal drugs use; * during pregnancy or lactation
impact of atypical antipsychotic therapy on health outcomes and costs among patients with major depressive disorder

Conditions: Depressive Disorder, Major

Summary: the primary objective is to examine changes in pre/post-augmentation healthcare costs and resource utilization in patients diagnosed with major depressive disorder (mdd) who augment their current antidepressant therapy with an atypical antipsychotic.


Eligibility criteria:
inclusion criteria: patients who meet the following criteria will be included in the study: * aged 18 to 64 years * diagnosis of major depressive disorder during the study timeframe (icd 9 codes 296.2, 296.3, 311) * evidence of at least 6 consecutive claims for traditional antidepressant therapy with a 30 day supply or at least 2 claims with a 90 day supply (consecutive defined as ≤15 days gap) * must be continually enrolled during the study timeframe and have both medical and pharmacy benefits * evidence of at least 4 consecutive claims for an atypical antipsychotic prescription with a 30 day supply or 2 claims with a 90 day supply (consecutive defined as ≤15 days gap) * evidence of antidepressant therapy for at least 60 consecutive days prior to the initiation of atypical antipsychotic * after at least a 60 day trial of traditional antidepressant medications, patient augments with an atypical antipsychotic medication for at least 4 months. exclusion criteria: patients are excluded if they: * have any claims for a diagnosis of schizophrenia, schizoaffective or bipolar disorder during the study period * have electroconvulsive therapy (ect) during the study period * new augmentation with mood stabilizers, l-thyroxine (t4), l-thyronine (t3), buspirone, stimulant, or others during the post-period (table 1) * are pregnant during the study period * patients with medicare or medicaid
comparison of skin substitutes used in burn care

Conditions: Burns

Summary: the purpose of this study is to determine if using a dermal layer under skin grafts: 1. will reduce scar formation of skin grafts 2. will reduce burn wound contractures 3. will improve functional outcome of joints requiring grafts compare scarring outcome of dermal products

various skin substitutes are compared for healing, scar and functional and cosmetic outcomes.

Eligibility criteria:
inclusion criteria: * burn injury requiring grafting * 0 years-90 years exclusion criteria: * partial thickness burns only

Keywords: burns skin grafting alloderm integra homograft autograft burn scar
caudal epidural steroid injections for low back pain/sciatic lumbar pain

Conditions: Pain; Disability

Summary: the study hypothesis is that caudal epidural steroid injections provides short term relief to patients with persistent low back pain and sciatica due degenerative disc disease or lumbar spinal stenosis. patients will be evaluated wiht clinical examination and radiological examinations before injections. they will be followed up with questionnaires on pain and disability up to 6 months postinjection.


Eligibility criteria:
inclusion criteria: * low back pain and sciatica due to lumbar disc herniation or lumbar spinals stenosis exclusion criteria: * infection, cancer, allergy to steroids or anesthetic, non controlled diabetes or hypertension, clotting disorder
the outcome of the thrombopoietin receptor agonists in pediatric patient with persistent or chronic itp unresonsive to steroids

Conditions: Persistent or Chronic ITP Not Respnding to Steroids

Summary: immune thrombocytopenic purpura (itp) is an autoimmune disease characterized by a low platelet count, purpura, and hemorrhagic episodes caused by antiplatelet autoantibodies. the diagnosis is typically made by excluding the known causes of thrombocytopenia. igg autoantibodies sensitize the circulating platelets. it leads to the accelerated removal of these cells by antigen-presenting cells (macrophages) of the spleen and sometimes the liver or other components of the monocyte-macrophage system. the bone marrow compensates for platelet destruction by increasing platelet production. itp most often occurs in healthy children and young adults within a few weeks following a viral infection . new treatment guidelines have supported a shift from corticosteroids and splenectomy to newer medical treatments that mitigate the thrombocytopenia and avoid splenectomy. the thrombopoietin receptor agonists (tpo-ra), romiplostim, eltrombopag have markedly altered the treatment of itp. the thrombopoietin receptor agonists (tpo-ras) romiplostim and eltrombopag have shown high therapeutic activity in primary itp. romiplostim, a thrombopoiesis-stimulating peptibody, represents a new therapeutic option in adult refractory chronic immune thrombocytopenia (itp). this study aimed to assess the short-term efficacy and safety of romiplostim in children withchronic itp. the most commonly reported drug-related adverse effects include headache, nausea, and hepatobiliary laboratory abnormalities. long-term safety data in children are limited, and studies in adults have not revealed a clinically significant increased incidence of thrombosis, marrow fibrosis, or cataract formation. tpo-ra do not need to be continued forever; about a third of patients in the first year and about another third after two years have a remission. whether tpo-ra affect the itp pathophysiology and directly cause remission remains unclear. this review provides a personal overview of the diagnosis and treatment of itp with a focus on the mechanism of action of tpo-ra, their place in the treatment algorithm, unique aspects of their clinical use, adverse effects.


Eligibility criteria:
inclusion criteria: pediatric patients with persistent or chronic itp on thrombopoietin receptor agonists unresponsive to steroid. exclusion criteria: any patient with other causes of thrombocytopenia. any patient with chronic disease . any patient with acute itp . any newly diagnosed patient with itp.

Keywords: cbc
knack technique in post-menopausal women with stress urinary incontinence

Conditions: Urinary Incontinence,Stress

Summary: to determine the effects of pelvic floor muscle exercise with and without knack technique in post-menopausal women with stress urinary incontinence


Eligibility criteria:
inclusion criteria: * post-menopausal women * multiparous women * previous history of vaginal deliveries * women with mild to moderate stress or mixed incontinence (with predominance of sui) via the 3 incontinence questions (3iq) * able to have a gynecological examination exclusion criteria: * symptoms of overactive bladder alone * previous participation in a pelvic floor re-education program and/or previous pelvic floor surgery or currently receiving other treatment for urinary incontinence. * loss of stools or mucus * active urinary or vaginal infection in the past 3 months

Keywords: exercise pelvic floor post menopause urinary incontinence
dir/ floortime™ parent training intervention for the children with developmental disabilities

Conditions: Cerebral Palsy; Down's Syndrome; Delayed Development

Summary: the objective of this study is to test whether adding the parent training program using the relationship-based approach could help the children with development disabilities (dds) would confer additional benefits over routine clinical care available to both groups in terms of improving their development and reducing behavior problems.

the objective of this study is to test whether adding the parent training program using the relationship-based approach could help the children with development disabilities (dds) would confer additional benefits over routine clinical care available to both groups in terms of improving their development and reducing behavior problems. the study treatment involves intervention entirely with parents of children with dds, rather than directly with the children themselves. before the first session, all parents in the intervention group had to learn about dir/ floortime™ model approach through 1 - hour one on one coaching (at the beginning oft the study, the end of 1st and 3rd month) and through 2 hours dvd lecture and a pocket book. the parent in the intervention group will be asked to carry out floortimetm together with using floortime strategies during daily activities a minimum of 15 hour per week. meanwhile, the children in the control groups will continue their routine care. the baseline assessment and follow up time schedule were similar to those of the intervention group.

Eligibility criteria:
inclusion criteria: the children with developmental disabilities : 1. age between 2 - 6 years of age 2. ambulatory 3. living with the primary caregiver for at least 6 months. exclusion criteria: the children are excluded if : 1. autism 2. deaf 3. blind 4. serious medical problems (e.g. severe congenital heart disease, intractable seizure (a seizure frequency of at least one attack per month during six months despite receiving two anticonvulsant drugs) 5. their parents : not literate, has known chronic psychiatric, or physical illness

Keywords: parent training dir/ floortime approach children with developmental disabilities
post-operative ct follow up after nellix endoprosthesis implantation

Conditions: Abdominal Aortic Aneurysm; Endovascular Aortic Repair; Nellix Endovascular Sealing

Summary: multicenter retrospective ct follow up after aortic aneurysm repair using nellix endoprosthesis.

rationale: in patients with abdominal aortic aneurysms the nellix endoprosthesis aims to reduce post-operative complications and subsequent re-intervention rates. using two stents covered with two polymer filled endobags used for sealing and excluding the aneurysm sac. preliminary results show promising results in reducing these complications. the new endoprosthesis is not only different in treatment but also in follow up imaging. to date it is unknown how the stent, polymer filled endobags and aneurysm appear in ct imaging in short and long term follow up. objective: to assess and describe the normal computed tomography (ct) appearance at 30 days and 1 year after implantation of the nellix endoprosthesis. study population: approximately a total of 100 patients who underwent endovascular aneurysm repair using nellix endoprosthesis in three different hospitals. the population is comprised of approximately fifty patients from rijnstate ziekenhuis arnhem and twenty-five each from st. antonius nieuwegein and st. elisabeth tilburg. design and methods: the study is designed as a multicenter retrospective cohort. using ct-scans from regular follow up dates (30 days and 1 year) imaging will be retrospectively assessed using medical imaging software. main study endpoints are defined as followed: 1. changes in the infrarenal neck morphology (below the renal arteries) 2. changes in the thrombus in the aneurysm sac 3. changes in the aneurysm wall and geometry 4. changes in the cobalt-chromium stent and their lumen 5. changes in the polymer-filled endobags using anonymous patient data a database will be created an securely stored. patient consent for study participation will be attained before accessing patient files. nature and extent of the burden and risk associated with participation, benefit and group relatedness: the study will not bring an extra burden or risk for patients participating. patients are encouraged to participate to improve insight for patients with the same disease and might improve health care in the future for this group of patients.

Eligibility criteria:
inclusion criteria: * patients who underwent endovascular abdominal aneurysm repair using the nellix endoprosthesis exclusion criteria: * no specific exclusion criteria
radial medical - gaps

Conditions: Osteoarthritis

Summary: this study will prospectively compare compliance rates between a novel fda cleared wearable compression therapy with and without digital engagement for dvt prophylaxis in both hospital and home environments after total knee or hip arthroplasty.

this study is a single-arm, open-label, prospective, single-center study designed to evaluate compliance to cirvotm therapy use with and without digital engagement. historical questionnaire data with a different compression device will be compared to the same questionnaire used for the prospective cohort of up to 200 subjects. all patients prescribed compression therapy following total joint arthroscopy will be offered participation. subjects will receive cirvotm compression therapy according to the standard of care protocol at nyu during or after surgery and 18 hours per day for 14 days. 1. baseline: following consent, participants will provide demographic, medical history and information with respect to their elective orthopedic procedure and receive training on the cirvotm device. participants will be randomized to either digital engagement or no digital engagement groups. 2. post procedure: after the procedure, cirvotm device operation will be reviewed with the participant. 3. discharge: any adverse events occurring during hospitalization will be reviewed, data capture on the cirvotm app will be confirmed. 4. 14- day visit: participants will complete a patient satisfaction questionnaire, provide information with respect to any adverse events including specific details about dvt and readmission and return the devices. 5. 30-day phone call/visit: participants will be contacted at 30 days to answer questions about dvt's and readmissions.

Eligibility criteria:
inclusion criteria: * male or female over the age of 18 * undergoing elective primary total hip/knee replacement * planned discharge to home * able to train to and operate the cirvo device with app exclusion criteria: * history of pulmonary embolism * active cancer * bmi \>40 * current smoker * history of a hyper-coaguable condition * actual or expected prolonged bedrest for \>3 days * calf geometry on which cirvo device does not appropriately fit (prospective cohort only) * known sensitivity to any of the materials used in the cirvo device (prospective cohort only) * currently participating or planning to participate in any other investigational clinical evaluation during study period that may, in the opinion of the investigator, affect compliance (prospective cohort only)